COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. :
Index No. Calendar No.
NAME OF COURT:
ADR Information :Form JUDICIAL SUBPOENA Plaintiff(s)
-againstThis form should be filled out and returned, within 10 days of the resolution of the dispute, to:
: : :
Defendant(s) : ... . .. .... ........ ......... ...... 2. . Type. of.civil. case: . . . . PI/PD-Auto . . . . . . PI/PD-Other . . . . . . Contract .
3. Date complaint filed 4. Date of ADR conference 6. Amount in controversy 7. TO Plaintiff's Attorney
1. Case name:
No. Other (specify):
Date case resolved 5. Number of parties $25,000$50,000 $50,000$100,000 8. over $100,000 (specify): Cross Defendant's Attorney
THE PEOPLE OF THE STATE OF NEW YORK $0$25,000
Cross Complainant's Attorney
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before TELEPHONE NUMBER , the Honorable your relationship to the case: at the Court 9. Please indicate located at County of Plaintiff Plaintiff's attorney Defendant Defendant's at any recessed in room , on the day of , 20 , at o'clock in the noon, and attorney or adjourneddefendanttestify and give evidence asattorney in this action Other (specify): the on the part of 3rd party date, to 3rd party defendant's a witness
10. Dispute resolution process: Mediation Arbitration Neutral case evaluation Other (specify):
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to 11. the party case resolved? How was on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a a. As a direct result of the ADR result of your failure to comply. process.
b. As an indirect result of the ADR process. c. Resolution was unrelated to ADR process.
Witness, Honorable , one of the Justices costs) 12. Check the closest dollar amount that you estimate you saved (attorneys fees, expert witness fees, and otherof the by using Court in resolution process compareddayresolving this case 20 County, , through litigation, whether by settlement or trial. this dispute to of
$0 $250 $500 $750 $1,000 more than $1,000 (specify): $
13. If the dispute resolution process caused a net increase in your costs in this case, check the closest dollar amount of the (Attorney must sign above and type name below) additional cost: $0 $250 $500 $750 $1,000 more than $1,000 (specify): $
14. Check the closest number of court days that you estimate the court saved (motions, hearings, conferences, trial, etc.) as a Attorney(s) for result of this case being referred to this dispute resolution process: 0 1 day more than 1 day (specify): 15. If the dispute resolution process caused a net increase in court time for this case, check the closest number of additional Office and P.O. Address court days: 0 1 day more than 1 day (specify): Yes Telephone No.: Facsimile No.: E-Mail Address: ADR INFORMATION FORM Tel. No.: Mobile No
16. Would you be willing to consider using this dispute resolution process again?
Form Adopted by the Judicial Council of California ADR-101 [New March 1, 1994]
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